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General NPI Number Information
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NPI Number | 1619238391
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Entity Type | Organization
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Legal Business Name | GIVING BACK INC
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 2356 W INDUSTRIAL PARK DR
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City | BLOOMINGTON
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State | IN
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Zip | 47404-2689
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Country | US
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Telephone | 812-929-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 8455 S SHOREVIEW DR
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City | TRAFALGAR
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State | IN
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Zip | 46181-8811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KELLY COLLIER
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Credential |
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Telephone | 812-929-0428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 120128131
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License Number State | IN
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